Radically curable urethane dimethacrylates and compositions thereof for tougher dental prosthetics

ABSTRACT

A radically curable polyurethane composite for dental restorations, including provisional restorations, includes polyurethane dimethacrylate prepolymers that have at least one flexible unit within a polyurethane dimethacrylate backbone, and one or more dimethacrylate monomers. Composite materials made with polyurethane dimethacrylate prepolymers of the invention exhibit superior and optimal properties of flexural strength and deflection-at-break relative to conventional dental resin composites. Composite materials of the invention also provide improved melt-resistance in response to the heat of grinding or finishing, thereby improving the fit of restorations made from the composite and preserving the finishing instruments. Methods of treating a tooth using the radically curable polyurethane composite and methods of making the polyurethane dimethacrylate prepolymers with flexible units is also provided. A kit including the radically curable polyurethane composite is also described.

TECHNICAL FIELD

The present invention relates to radically curable polyurethanedimethacrylate prepolymers having flexible units and the synthesis anduse thereof for the preparation of dental restorative materials.

BACKGROUND ART

Composite-based resins have made significant contributions torestorative dentistry. Improvements in such resins have facilitated anincrease in prosthodontic therapy and aesthetic dentistry. One of theprincipal uses of composite resins is in the manufacture and applicationof provisional restorations. Provisional restorations are temporaryprostheses that are placed on, or in place of, one or more teeth for alimited period, from several days to several months, and in some caseseven longer, and which are designed to protect the tooth or teeth,provide masticatory function, maintain proper alignment of adjacent andopposing teeth, and remain in position until a permanent restoration isfacilitated. As can be readily understood, the resin that comprises aprovisional restoration must have the durability, toughness and physicalproperties to withstand mastication of hard food while maintaining atight fit to the underlying tooth or teeth. It must also have anaesthetic appearance that matches or improves upon the appearance of theoriginal teeth.

Dental resins typically contain three primary ingredients: (1) anorganic binder or matrix of monomers; (2) inorganic filler; and (3) acoupling agent, often incorporated into a polymerization system. Thequalities of the individual components that comprise a resin,particularly the monomers used, as well as synergistic propertiesderived from particular combinations of components, have an enormousimpact on the aesthetic quality, durability and clinical utility of theresin. The most desirable resins possess high impact strength, highelasticity, high hardness, and dimensional stability with littletendency to swell through water absorption (which lowers strength).

The organic binder of composite resins is made up of a system of mono-,di- or tri-functional monomers. The monomer system can be viewed as thebackbone of the composite resin system. Suitable monomers includeethylenically unsaturated compounds such as acrylic acid and methacrylicacid esters.

Filler particles vary from one composite-based resin to another, andeach type of filler has its own distinctive characteristic. The fillerportion of a composite-based resin has a significant effect on thequalities of the cured composite. For example, the size of a givenfiller particle can affect roughness and strength. As a general rule,the higher the loading of filler, the higher the strength of the finalcomposite-based resin.

A polymerization system is often comprised of several components. Theseinclude polymerization initiators specific for a given type ofpolymerization system. For example, in chemically-activated systems,benzoyl peroxide and tertiary amines serve as a source of free radicals,which create propagating sites of polymerizing reactivity incarbon-carbon double bonds of the monomers. For light-activated resincomposites, a diketone photoactivator is typically used.

Polymerization systems may also contain coupling agents to bond thefiller particles to the organic resin matrix via silanating agents. Thisserves to improve the resin's physical properties by preventinghydrolytic breakdown along the filler/matrix interface. Hydrolyticbreakdown of the filler/matrix interface can crack the resin throughstress transfer.

Acrylic dental resins have been in use for over fifty years and continueto be used for the fabrication of provisional restorations. Thesematerials are typically polymethylmethacrylate (PMMA) and methylmethacrylate (MMA). With acrylic resin, the fabrication of theprovisional restoration usually requires mixing a powder and liquidtogether to form a paste that is placed in either a premade shell (toothform), or into a template or carrier that is placed over the toothpreparation. These materials have adequate strength, are tooth-coloredand have relatively good color stability over a few weeks. They can besmoothed and polished, are easily repaired, and are relativelyinexpensive. PMMA resins have a sufficiently high glass transitiontemperature (Tg) to allow trimming, grinding and finishing of the curedmaterial without causing the material to soften or distort. Tg is thetemperature at which a polymer goes from a hard, glass-like state to arubber state. Since PMMA resins have a sufficiently high Tg, the heat ofthe grinding and finishing wheel used to trim, shape and finish themargins of the provisional restoration does not distort the resin. Thematerial grinds and powders providing crisp and accurate margins. Theaccurate margins provide a good adaptation to the tooth preparation andgingival tissue.

However, repeated mixing of powder and liquid exposes the dentist and/ordental assistant to monomers that may be cytotoxic to users undercertain conditions. Allergies to PMMA monomers are well documented, andthese allergic reactions can be quite severe. PMMA products also havestrong and objectionable odors. Furthermore, precise dispensing of PMMAproducts is difficult and mixing ratios generally vary according to userexperience and desires. Because of these variations in proportions andmixing skills, physical properties can vary, irritation to oral mucosacan be exacerbated and there can be an increase in the exothermicreaction, heat gain, which can produce negative effects on the dentalpulp if not mitigated with specific, seldom used additional techniquesand materials.

In addition, PMMA materials are well known for shrinkage duringpolymerization leading to poorly fitting restorations. Following theinitial insertion of the carrier matrix (template) filled with PMMA, thecarrier matrix with partially polymerized PMMA restoration is removedfrom the mouth before the final set, and complete polymerization andhardening continues outside the mouth. The torque and manipulationapplied when removing the carrier matrix can distort the provisionalrestoration, adding another contributing factor to the poor fit of PMMAprovisional restorations.

Additional shrinkage continues to occur over time in the mouth due tothe constant exposure to moisture in the oral environment. The changingdimensions of the PMMA restoration change the way the prostheses fit,causing them to come loose, and a PMMA restoration may need to berelined in cases deemed long term. The effect of shrinkage at themargins increases the micro-leakage of bacteria and may allowre-infection of the tooth prior to the placement of the finalrestoration.

Due to the deficiencies of the aforementioned PMMA acrylic resins,Bis-acrylic resins have become a popular material for provisionalrestorations. Bis-acrylic composites have less exotherm, are easier tomix precisely due to automix dispensing systems, are more polishable,more color stable, have better physical properties and shrink less thanPMMA resins.

However, Bis-acrylics have a number of prominent disadvantages,including high cost, low Tg, difficulty in making repairs, brittleness,frequent breaking at pontic areas, suitability for single-unitprovisionals only, and frequent debondings requiring re-cementation.Unique to bis-acrylic resins is a low glass transition temperatureresulting in gumming up of finishing instruments and the routinesoftening and loss of margins at the tooth preparation interface.Bis-acrylics soften from the heat produced by the grinding and finishinginstruments, and this distorts the margins. The bis-acrylic must then berelined and the margins must be re-established with flowable composites.This aspect is time consuming and may create resin compatibility issues.Marginal integrity is critical to proper fit and the health of thegingival tissue.

Bis-acrylics have adequate flexural and compressive strengths, but arequite brittle, lacking the desired toughness and deflection at break.Also, they do not have a sufficient “memory effect” (also referred to as“temporary flexibility effect”) to maintain an optimal marginal fit.

Increasing toughness and flexibility without sacrificing otherproperties is a great advantage in dental restorative applications.Various approaches have been tried to address these issues. In 1994, Mayet al. (U.S. Pat. No. 5,376,691) disclosed adding non-polymerizableadditives (such as polyethylene glycol) or plasticizers (such as estersof phthalates), but these approaches yield polymers with inferiormechanical properties such as brittleness, incomplete curing, phaseseparation and leaching of non-polymerized additives. Recently, Orlowskiet al. disclosed the use of polybutene in acrylate resins to increasethe flexibility and decrease the brittleness of dental prostheticmaterials. However, polybutenes are non-polymerizable, low Tg materialsand may create micro-nonhomogenieties in the resin; polybutenes mayleach out of the cured resin matrix, decreasing the durability of thedental composite; and the addition of polybutenes will not eliminate thegumming of the crowns and bridge material on polishing.

Urethane dimethacrylate resins have been used to fabricate dentalprostheses. Urethane dimethacrylate resins have excellent flexuralcharacteristics but lack flexibility. Also, high amounts of lowmolecular weight diurethane dimethacrylate in the resin formulationincreases the exothermic heat and increases polymerization shrinkage dueto the high concentration of double bonds.

SUMMARY OF EMBODIMENTS

Embodiments of the present invention provide a radically curableurethane dimethacrylate composite for dental restorations that providessuperior and synergistic properties of hardness, toughness and flexuralstrength while maintaining the aesthetics required of dental materials.

In one embodiment of the invention, a radically curable polyurethanecomposite for dental restoration is provided. The composite includes (A)about 5-45% by total weight of the composite of a polyurethanedimethacrylate prepolymer blended in at least one aprotic methacrylatemonomer, wherein the prepolymer includes at least one flexible unitwithin a polyurethane dimethacrylate backbone, and (B) about 15-60% bytotal weight of the composite of one or more dimethacrylate monomers. Inparticular embodiments, the flexible unit incorporated or inserted intothe backbone of the prepolymers may be hydrogenated polybutadiene diol,polyester diol, polyether diol and combinations thereof. In moreparticular embodiments, the composite includes a urethane dimethacrylatethat has at least one polybutadiene molecule within the urethanedimethacrylate. In various embodiments, the one or more dimethacrylatemonomers may be polyether dimethacrylate, alkyl dimethacrylate,polyester dimethacrylate and combinations thereof.

The aprotic methacrylate monomers may be triethylene glycoldimethacrylate, tetraethylene glycol dimethacrylate, polyethylene glycoldimethacrylate, polyethylene glycol methacrylate monomethyl ether,tetramethylene dimethacrylate, hexamethylene dimethacrylate,octamethylene dimethacrylate, and/or dodecamethylene dimethacrylate.

The radically curable polyurethane composite may also include aphotoinitiator system. The photoinitiator system may further include apolymerization inhibitor such as butylated hydroxytoluene orhydroquinone monomethyl ether, and combinations thereof. In certainembodiments, the photoinitiator system may comprise a light sensitivephotoinitiator selected from a group comprising camphorquinone, benzil,acylphosphine oxide, and an amine co-initiator. The radically curablepolyurethane composite of certain embodiments may further include anonreactive filler. This filler may be, for example, barium glass,barium borosilicate glass, strontium glass, quartz, submicron silica andcombinations thereof.

The radically curable polyurethane composite of certain embodiments mayfurther include a polymerization catalyst. The polymerization catalystmay be selected from a group comprising dibenzoyl peroxide,2,2-(4-methylphenylimino)diethanol, dimethylaminoethyl methacrylate,N,N-dimethyl-p-toluindine, N,N-dimethylaminoethyl-methacrylate,benzoinmethylether and combinations thereof.

The radically curable polyurethane composites of embodiments of theinvention are characterized by a number of superior properties thatfacilitate use in dental applications. For example, certain embodimentsmay be characterized by a deflection-at-break of 2.3 to 3.2 mm aftercuring.

Embodiments of the invention may also include methods of treating atooth. The methods generally include providing a radically curablepolyurethane composite for dental restoration, which includes (A) about5-45% by total weight of the composite of a polyurethane dimethacrylateprepolymer blended in at least one aprotic methacrylate monomer and theprepolymer includes at least one flexible unit within a polyurethanedimethacrylate backbone, and (B) about 15-60% by total weight of thecomposite of one or more dimethacrylate monomers. The method furtherincludes applying the composite material to at least a portion of asurface of one or more teeth and curing the polymerizable compositematerial so that the composite material polymerizes.

Particular embodiments of the methods disclosed herein further includethe addition of one or more dimethacrylate monomers, a catalyst, andnon-reactive filler to the composite. Furthermore, the flexible unit ofthe prepolymers may be polybutadiene diol, polyester diol and/orpolyether diol.

Additional embodiments of the methods may involve trimming thepolymerized composite so that it substantially replicates the surface ofone or more teeth and creates an anatomically correct margin.Optionally, a sealant may be applied to the polymerized composite. In aparticular embodiment, the polymerized composite includes a provisionaldental prosthesis.

Embodiments of the invention utilize a radically curable polyurethanedimethacrylate prepolymer for use in dental compositions. Theprepolymers include at least one reactive diol inserted within apolyurethane dimethacrylate backbone. In certain embodiments, thereactive diol may be hydrogenated polybutadiene diol, polyester dioland/or polyether diol. In more particular embodiments, the reactive diolmay be hydrogenated polybutadiene.

The radically curable polyurethane dimethacrylate prepolymers ofembodiments of the invention may be made or produced by reacting atleast one diisocyanate monomer with a reactive diol in the presence of acatalyst to form a diisocyanate-diol prepolymer and blending thediisocyanate prepolymer in at least one aprotic methyacrylate monomer.In certain embodiments, the diisocyanate monomer may be dicyclohexylmethane diisocyanate, tetramethyl xylene diisocyanate, isophoronediisocyanate, hexamethylene diisocyanate, 4,4diphenylmethanediisocyanate, and/or tolulene diisocyanate. The aprotic methacrylatemonomer may be triethylene glycol dimethacrylate, tetraethylene glycoldimethacrylate, polyethylene glycol dimethacrylate, polyethylene glycolmethacrylate monomethyl ether, tetramethylene dimethacrylate,hexamethylene dimethacrylate, octamethylene dimethacrylate, and/ordodecamethylene dimethacrylate. In certain embodiments, the reactivediol may be hydrogenated polybutadiene diol, polyester diol and/orpolyether diol.

In particular embodiments, the diisocyanate prepolymer may be furtherreacted with an ethylenically unsaturated monohydroxy compound. Theethylenically unsaturated monohydroxy compounds may be hydroxylpropylmethacrylate, hydroxylethylmethacrylate, hydroxyethyl acrylate,hydroxypropyl acrylate, monohydroxy caprolactone methacrylate, hydroxylbutyl methacrylate, and/or monohydroxy polyethylene glycol methacrylate.In a yet more particular embodiment, the diisocyanate-diol prepolymermay be formed by reacting isophorone diisocyante and saturatedhydroxyl-terminated polybutadiene in the presence of hexamethylenedimethacrylate and dibutyltin dilaurate to form a polyisocyanateprepolymer in 20% hexamethylene dimethacrylate. Additionally,2-hydroxyethylmethacrylate may be added in the presence of a phenolicinhibitor, and the reaction may be monitored with Fourier transforminfrared spectroscopy until no free isocyanate groups are detected. Inother embodiments, a phenolic polymerization inhibitor may be added tothe radically curable polyurethane dimethacrylate prepolymer.

Further embodiments of the invention comprise a dental restoration kitof a radically curable polyurethane composite, wherein the compositeincludes diisocyanate-polybutadine prepolymers and a provisionalsealant.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing features of embodiments will be more readily understood byreference to the following detailed description, taken with reference tothe accompanying drawing, in which:

FIG. 1 is a graph showing flexural load versus flexural extension(deflection) for various materials compared to embodiments of thepresent invention.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

Polyurethane dimethacrylates are produced by the polyaddition reactionof a polyisocyanate with a polyalcohol or diol in the presence of acatalyst and other additives and then end-capping with a monohydroxymethacrylate. In the present disclosure, a prepolymer is obtained by theaddition reaction of a diisocyanate and a diol end-capped with amonohydroxy methacrylate. The reaction product is a polymer containingthe urethane linkage, —RNHCOOR′—.

Polyurethanes with various flexible units may be synthesized and used inthe preparation of flexible coatings, elastomers, and other applicationswhere toughness and flexibility are required. Polyurethanes withflexible polyester soft segments lack hydrolytic stability andpolyurethanes with polyether segments (e.g., U.S. Pat. No. 7,494,339)tend to absorb water and lose dimensional stability.

Polybutadienes may be used for the preparation of toughenedpolyurethanes. Uses include the preparation of golf balls (U.S. Pat. No.7,604,552) and flexible coatings (U.S. Pat. No. 6,747,097 and USapplication no. 20070052796). An example is a commercially availablepolybutadiene methacrylate, CN301 from Sartomer. However, this materialhas been found to be aesthetically inferior and to be incompatible withmonomers used in these formulations.

Embodiments of the present invention relate to polymerizablepolyurethane composite resins and methods of making and using suchmaterials in dental prosthetics. Embodiments of the present inventionprovide a polymerizable polyurethane dimethyacrylate composite materialfor dental applications with improved strength, elasticity, hardness andaesthetics. Surprisingly, it has been found that these qualities can beobtained with the incorporation of suitable flexible units, such ashydrogenated polybutadiene, polyolefins, polyesters and polyethers,within the backbone of a polyurethane dimethacrylate prepolymer. Thecomposite material comprises a formulation of monomers and novelprepolymers that yield dental prostheses or crowns with resistance todiscoloration, and surprising and superior toughness anddeflection-at-break characteristics relative to conventional dentalresins.

Another notable feature of the radically curable polyurethane compositeof embodiments of the invention is its response to heat generated byfinishing or grinding. Upon such finishing or grinding, it transitionsto a powder rather than a soft, gum-like state. The “gumming” of atemporary crown during trimming or polishing can result in a poorfitting or loose crown, and may require a second patient visit to repairor fix the crown. Embodiments of the present invention, therefore,exhibit improved prosthetic fit and do not create a “gumming up” of thefinishing instruments. Without being limited to a particular principalof operation, it is believed that this effect is created by a relativelyhigh Tg of the polymerized composite.

The embodiments disclosed herein utilize a urethane dimethacrylateprepolymer prepared from hydrolytically and color-stable flexible units.Polyurethane dimethacrylate prepolymers for use in embodiments of theinvention may be prepared by the addition reaction of an aliphaticdiisocyanate and an odorless, clear saturated liquid polyol, which isend-capped with a hydroxyl methacrylate monomer. The use of saturatedpolyols as flexible units incorporated within a polyurethanedimethacrylate backbone provides light-stability and wear resistance,and enables a formulation with superior mechanical properties andresistance to heat and discoloration. Flexible units for use inembodiments of the present invention include, for example, hydrogenatedpolybutadiene diol, hydrogenated polyester diol, polyether diol, and/orpolyolefins.

The flexible units, therefore, comprise polyurethane dimethacrylateprepolymers for use in a radically curable polyurethane composite fordental restorative composition, including provisional restorations. Inparticular embodiments, the radically curable composite comprisespolyurethane dimethacrylate with flexible units, urethanedimethacrylate, alkyl dimethacrylates, glass fillers, free radicalcatalysts, activators and photoinitiators. The composite may beself-cured (also referred to as mix cure or chemical cure), heat cured,light cured (UV or other radiation) or may comprise a dual-cure system(a combination of self-cured and light-cured materials).

The amount of polyurethane dimethacrylate prepolymers with flexibleunits may vary from about 5-45% by total weight of the final compositematerial. Embodiments of the polyurethane composite also include onemore dimethacrylate monomers, which may vary from about 15-60% by totalweight of the final composition. Suitable dimethacrylate monomersinclude urethane dimethacrylate, polyether dimethacrylate, alkyldimethacrylate, polyester dimethacrylate and combinations thereof. Theamount of dimethacrylate monomers may be adjusted to control thestrength of the material through co-polymerization, enhancedpolymerization with additional co-monomers, and impart some furtherhydrophilic or hydrophobic characteristics to the material.2-hydroxyethyl methacrylate is an example of such a hydrophilicco-monomer. 1,6hexamethylene dimethacrylate is an example of ahydrophobic co-monomer.

The polymerizable polyurethane composite material includes polyurethanedimethacrylate prepolymers with at least one flexible unit, one or moredimethacrylate monomers, and may further include a nonreactive filler, apolymerization system, additional co-monomers, and water. The compositematerial may additionally contain other adjuncts to impart convenienthandling characteristics and satisfy setting or curing requirements andother suitable qualities useful in restorative dentistry. Depending onthe chemical configuration of the dimethacrylate monomers or otherco-monomers, significant differences in polymerization kinetics andmechanical properties of the formed dental resins, such as final doublebond conversion, modulus, flexural strength and hardness, volumeshrinkage, and biocompatibility, can be achieved. Co-monomers forembodiments of the invention include, but are not limited to,polymerizable compounds such as diurethane dimethacrylate;hydroxyethylmethacrylate; trimethyol propane trimethacrylate;1,6hexamethylene dimethacrylate; polyethylene glycol dimethacrylate; andbis glycidyl dimethacrylate (BIS-GMA).

Non-reactive fillers suitable for embodiments of this invention are onesthat will not react with the organic matrix. Nonreactive fillers used inembodiments of the invention include barium glass, barium borosilicateglass, strontium glass, quartz, submicron silica and combinationsthereof, and other materials well known to those skilled in the art. Thefiller is made up of particles used to impart strength to the compositestructure. The filler may contain particles of varying sizes. Forexample, the filler may include micron-sized or submicron-sizedparticles of silica (SiO.sub.2). Micron-sized particles typicallyprovide density, while submicron-sized particles typically act as athickening and suspending agent. Further, the particles may besilanated, i.e., have a coating of silane. The amount of filler variesfrom about 1% to 80% by weight, depending on whether the material isused as a glaze suitable for sealing a margin of a restoration or forsealing a pre-carious lesion, or as a highly filled, restorativematerial suitable for high strength, low wear applications such as ClassI or Class II restorations. An intermediate filled material, in therange of about 25-50% by weight, would be suitable for placement as apit and fissure sealant, and as a Class I, Class III, Class IV or ClassV restorative material.

The polymerization system can be activated by heat (heat cured),chemicals (self-cured, mix cured), light or combinations thereof(dual-cure). Light-activated (or photocurable) resins depend on freeradical initiation by an alpha diketone (e.g., camphoroquinone) incombination with a tertiary aliphatic amine reducing agent (e.g.,4-n,n-dimethylamino-phenyl-ethanol, or dimethylamino ethylmethacrylate). Chemically-curable resins use an initiator of benzoylperoxide or other organic peroxide in combination with an aromatictertiary amine (n,n-dihydroxyethyl-p-toluidine).

In certain embodiments of the invention, light curing compounds orphotoinitiators include such compounds as camphorquinone, acylphosphineoxide (Lucerin TPO®), benzil, methyl benzil ether, andphenyl-propanedione. Other photoinitiators that may be used are known tothose skilled in the art.

The polymerization system may also contain an accelerator (e.g,dimethylaminoethyl methacrylate, ethyl-4 dimethylaminobenzoate, orN,N-cyanoethyl-methylaniline), which acts on the initiator and allowscuring to take place in a clinically acceptable time. Other acceleratorsthat may be used are known to those skilled in the art.

Two-part chemical cure formulas of embodiments of this invention mayrequire separation of polymerization accelerators from the initiator.Such an initiator may include benzoyl peroxide, cumene hydroperoxide,lauryl peroxide or any of a number of widely recognized organicperoxides for free radical or cationic/anionic polymerization reactions.

Composite resins of embodiments of the invention may also contain astabilizer or inhibitor system such as hydroquinone monomethyl ether toextend the product's storage life by restricting spontaneouspolymerization, decreasing sensitivity to ambient light and prolongingworking time before the resin sets. The polymerization system may alsocontain absorbers of ultraviolet light at wavelengths below 350 nm, suchas 2-hydroxy-4-methoxybenzophenone, to provide color stability andeliminate the effects of UV light on the amine compounds in theinitiator system, which can cause discoloration.

To facilitate manufacturing and clinical handling, embodiments of theinvention may be diluted with other low-viscosity (i.e., low molecularweight) monomers, which are considered viscosity controllers. Examplesinclude bisphenol A dimethacrylate (Bis-DMA), ethylene glycoldimethacrylate (EGDMA), triethylene glycol dimethacrylate (TEGDMA),methyl methacrylate (MMA) and/or urethane dimethacrylate (UDMA).

In particular embodiments of the invention, flexibility and strength isimparted to the composite resin through a radically curable diurethaneprepolymer that includes at least one reactive diol inserted within apolyurethane dimethacrylate backbone. The incorporation of the reactivediol or other long alkyl or alkene units enhances flexibility. In thiscapacity, the reactive diol functions as a flexible unit.

In certain embodiments, the reactive diol is selected from a groupcomprising hydrogenated polybutadiene diol, polyolefin diol,hydrogenated polyester diol and polyether diol. In yet more particularembodiments, the incorporation of suitable long flexible units isaccomplished by inserting at least one hydrogenated or saturatedpolybutadiene diol within a diurethane dimethacrylate backbone, suchthat a diisocyanate-diol prepolymer is formed, which may be representedby the formula:

wherein R is an organic chain.

The incorporation of flexible units within a urethane dimethacrylatebackbone as utilized in embodiments of the invention achieves unexpectedand surprising results in flexural strength and toughness (as determinedby deflection-at-break properties). Whereas ordinary composite resinsare limited by a tradeoff between flexural strength and toughness,embodiments of the present invention achieve synergistic levels of bothproperties.

In addition to these superior material properties, embodiments of theinvention possess the aesthetic properties required for dentalapplications. Principally, the composite resins disclosed herein aresurprisingly resistant to discoloration. Particular embodiments of theinvention incorporate hydrogenated (or saturated) flexible units,thereby eliminating many of the functional double bonds that may be asource of discoloration upon oxidation or UV irradiation.

In one particular embodiment of the invention, a polyurethanedimethacrylate with flexible units is prepared by charging 590 parts ofa commercially available hydrogenated polybutadiene polyol (e.g.,Krasol® Hydrogenated Hydroxyl-Terminated Polyolefin), 200 parts ofhexamethylene dimethacrylate monomer and 130.7 parts of isophoronediisocyante in a steel reaction vessel equipped with mechanical stirrerand thermometer. The hydroxyl:isocyanate ratio of the rubber diol todiisocyanate is optimal at approximately 1:2. A catalyst such as dibutyltin dilaurate (150 ppm) is added. The reaction is continued at 70-80° C.for approximately 3 hours. The temperature is then lowered to 40-50° C.and 82 parts of 2-hydroxyethyl methacrylate monomer containing 2400 ppmmonohydroxy hydroquinone (MEHQ) inhibitor added. The temperature of thereaction is then increased again to 70-80° C. This reaction results indiisocyanate-diol prepolymers of a urethane dimethacrylate backbone withpolybutadiene incorporated therein, or “rubberized” urethanedimethacrylate, blended in 20% hexamethylene dimethacrylate. Theprepolymers may have a Brookfield viscosity of approximately 30,000 cPand an inhibitor concentration of 200 ppm.

In other embodiments, the prepolymers comprise a flexible polyester orpolyolefin unit within a diurethane dimethacrylate backbone. Theseembodiments, and the components used in their synthesis, may berepresented by the following formulas, wherein R₁ and R₂ are any alkylchain and R₃ is a urethane unit with a polyester or polyolefin chain.

A polyurethane dimethacrylate with polyester flexible units may beprepared by charging 526 parts of a polyester diol with a molecularweight of approximately 1000 (e.g., Oxyester® T1136 from Degussa), 130parts of polyethylene glycol dimethacrylate monomer, and 208 parts ofisophorone diisocyante in a steel reaction vessel equipped withmechanical a stirrer and thermometer. The hydroxyl:isocyanate ratio ofthe diol to diisocyanate is optimal at approximately 1:2. A catalystsuch as dibutyl tin dilaurate (150 ppm) is added. The reaction iscontinued at 70-80° C. for approximately 3 hours. The temperature islowered to 40-50° C., and 132 parts of 2-hydroxyethyl methacrylatemonomer containing 2400 ppm monohydroxy hydroquinone (MEHQ) inhibitor isadded. The temperature of the reaction is then further increased to70-80° C. The result of this reaction is polyurethane dimethacrylateprepolymers with polyester flexible units incorporated therein, blendedin 14% polyethylene glycol dimethacrylate. The product may have aBrookfield viscosity of 45,000 cP and an inhibitor concentration of 200ppm.

Diisocyanate monomers for use in the examples above and in otherembodiments of the invention include dicyclohexyl methane diisocyanate,tetramethyl xylene diisocyanate, isophorone diisocyanate, hexamethylenediisocyanate, 4,4diphenylmethane diisocyanate, and tolulenediisocyanate.

The prepolymers are blended in at least one aprotic methacrylatemonomer. These monomers may be selected from a group comprisingtriethylene glycol dimethacrylate, tetraethylene glycol dimethacrylate,polyethylene glycol dimethacrylate, polyethylene glycol methacrylatemonomethyl ether, tetramethylene dimethacrylate, hexamethylenedimethacrylate, octmethylene dimethacrylate, and dodecamethylenedimethacrylate.

In alternative embodiments, the diisocyanate prepolymer may be reactedwith an ethylenically unsaturated monohydroxy compound selected from agroup comprising hydroxyl propyl methacrylate,hydroxylethylmethacrylate, hydroxyethyl acrylate, hydroxypropylacrylate, monohydroxy caprolactone methacrylate, hydroxyl butylmethacrylate, and monohydroxy polyethylene glycol methacrylate.

It should be readily understood that in addition to the polybutadieneand polyester diols discussed above, other reactive diols may used togenerate the prepolymers of embodiments of the invention. Other reactivediols include polyether and polyolefin.

Both the superior material and aesthetic properties (as well as otherhygienic properties) of certain embodiments of the invention may beenhanced by ensuring that the polyurethane dimethacrylate prepolymerswith flexible units are made under reaction conditions that arecontinued until no free isocyanate groups remain. An absence of freeisocyanate indicated the conversion of monomers to prepolymers. In otherwords, it is a reflection of reacted versus unreacted material. Reducingthe content of unreacted diisocyanate in the reaction by ensuringcomplete polymerization of the prepolymers reduces toxicity and improvesmechanical performance. The absence of free isocyanate may be confirmedby Fourier transform infrared spectroscopy (FTIR) or other suitablemeans known to those of skill in the art. For example, the reactionsabove may be continued until the FTIR shows no peak corresponding to thefree isocyanate group (2270 cm⁻¹). The absence of free isocyanate may befurther confirmed by titration.

A method of using the composite material includes providing thecomposite material, applying it to one or more teeth, and then curing byactivating the polymerization system such as by applying light toactivate a light curing compound. For dual cure formulations, thematerials are mixed together prior to application to the tooth.

When the composite material is used for treating a tooth, it may betrimmed so that it substantially replicates the surface of one or moreteeth and creates an anatomically correct margin. In particularembodiments, the anatomically correct margin may be such that thetooth-to-restoration contact is not visible to the naked eye. A sealantmay optionally be applied to the polymerized composite.

The polymerized composite may comprise a provisional dental prostheses.In alternative embodiments, the polymerized composite may comprise partof a permanent or semi-permanent dental prosthetic such as a crown orbridge, a denture or partial denture, or an orthodontic appliance.

The composite material may be applied as a two-part polymerizationsystem with an accelerator side and a catalyst side. The acceleratorside may comprise the polyurethane dimethacrylate prepolymers withflexible units end-capped with a hydroxyl methacrylate monomer. Theaccelerator side may further comprise one or more dimethacrylatecomonomers, one or more non-reactive fillers, a photoinitiator system,amine and butylated hydroxy toluene to protect the polymers fromoxidative degradation. The catalyst side may comprise one or moredimethacrylate comonomers, one or more non-reactive fillers, apolymerization catalyst (e.g., benzoyl peroxide) and butylated hydroxytoluene. Other components as known to those skilled in the art may beincluded in either side of the reaction to modify the polymerizationreaction and the properties of the polymerized composite.

The two-part system may comprise the acceleration side and the catalystside in separate chambers of syringe-type dispensers. Other suitabledispensers may be used as known to those of skill in the art. Thesyringes may be packaged as part of a kit for dental restorations. Thekit may also contain a sealant, glaze, add-on or other components toenhance the aesthetics of a provisional restoration made with the kit.

To further illustrate the attributes of embodiments of the presentinvention and the qualities imparted to the composite materials by thepolyurethane dimethacrylate prepolymers, the following examples areprovided. However, embodiments of the present invention are not to beconstrued as being limited thereto. Unless otherwise indicated, allpercentages are by weight.

In the following examples, the polyurethane dimethacrylate prepolymerswith flexible units are prepared using either hydrogenated polybutadienediol (examples 4, 6-7) or polyester (example 5) as the “flexible”polyol.

Test Methods

Flexural strength and deflection at break were determined by using athree point bending test as specified by ISO specifications 4049. Theflexural test specimens were fabricated according to a group 4049specification (25 mm length×2 mm width×2 mm thickness) using apolypropylene mold (n=5 per materials, storage conditions,formulations). The material was injected into the mold, and afterinjection the mold was covered with a transparent Mylar film and a glassplate tightly placed over the mold. The mold was then placed in anincubator at 37° C. for 10 min. Excess material was removed by wetgrinding on 600 grit silicon carbide paper directly before testing andthe specimen's width and thickness were measured using a digitalmicrometer. The Flexural strength and deflection at break were measuredon an Instron Model 1011 Universal testing machine used at crossheadspeed of 1 mm/min to record the stress-strain curve and determine thedeflection and force at break. The flexural strength was calculatedusing FS=3FL/2bt², where F is the Force (N) at break, L=span length(mm), b is the width (mm) and t is the thickness (mm).

The toughness of the materials was determined by measuring the areaunder the stress-strain curve obtained from the flexural strengthmeasurements.

For compressive strength measurements (n=5), specimens were fabricatedby injecting material into a polypropylene cylindrical molds of 4 mmdiameter and 6 mm length. The material was allowed to cure at 37° C. for10 min. The diameter and length of the specimens were measured using amicrometer. The compressive strengths of the specimens were measured ona Instron Universal analyzer with a crosshead speed of 10 mm/min. Theforce at break is then calculated as CS=Force at break(N)/Area ofcross-section.

One of the major problems associated with resin-matrix composite (inparticular crown and bridge material) that leads to failure ofrestorations is fracture within the body of restorations. This isrelated to many factors such as flexural strength, fracture toughness,marginal disintegration under stress, quality of fit, and toughness ofthe materials. These properties are usually evaluated by testingflexural strength, flexural modulus, and toughness of the materials.

Temporary crown and bridge materials should have optimum characteristicsand toughness or deflection at break. The initial (within 10 min. offabrication) flexural strength and flexural modulus of the material isof a great concern as this is the period at which plastic deformation ofthe prostheses, while removing the material from the fabrication sitetakes place. This deformation can cause loose fitting crowns andbridges. The 10 min. and 24 h flexural properties of provisional crownand bridge materials are presented in Table 1.

Example 1

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 27.0 Polyurethanedimethacrylate 0.0 with Flexible Units polyether dimethacrylate 7.5alkyl dimethacrylate 26.5 Glass filler 33.0 amorphous silica 5.2photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 71.2

Deflection-at-break (mm): 1.8

Compressive strength (Mpa): 300

Results:

Example 1 demonstrates a polymerized composite material withoutinclusion of polyurethane dimethacrylate prepolymers with flexibleunits. Although this example has excellent flexural and compressivestrength, it is extremely brittle, as reflected in its lowdeflection-at-break value. This brittleness results in poor fit whenused to make a dental prosthetic and lessens the durability of thecomposite.

Example 2

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 27.0 Polyurethanedimethacrylate 0.0 with Flexible Units polyether dimethacrylate 26.5alkyl dimethacrylate 7.5 Glass filler 33.0 amorphous silica 5.2photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 43.3

Deflection-at-break (mm): 3.4

Compressive strength (Mpa): 226

Results:

Example 2 demonstrates another polymerized composite materialformulation without inclusion of polyurethane dimethacrylate prepolymerswith flexible units. In this particular formulation, it can be seen thatalthough the composite material exhibits excellent deflection-at-break,its flexural strength is poor.

Example 3

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 27.0 Polyurethanedimethacrylate 0.0 with Flexible Units polyether dimethacrylate 7.2alkyl dimethacrylate 7.5 Polybutadiene dimethacrylate 19.2 Glass filler33.0 amorphous silica 5.2 photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 58.5

Deflection-at-break (mm): 1.8

Compressive strength (Mpa): 186

Results:

Example 3 demonstrates yet another polymerized composite materialformulation without inclusion of polyurethane dimethacrylate prepolymerswith flexible units. In this particular formulation, neither theflexural strength nor deflection-at-break properties are optimal fordental applications.

Example 4

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 27.0 Polyurethanedimethacrylate 19.6 with HPB Flexible Units polyether dimethacrylate 7.2alkyl dimethacrylate 7.2 Glass filler 33.0 amorphous silica 5.2photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 66.0

Deflection-at-break (mm): 2.6

Compressive strength (Mpa): 196

Results:

Example 4 demonstrates properties derived by inclusion of thepolyurethane dimethacrylate prepolymers wherein the flexible unit ishydrogenated polybutadiene (HPB) of embodiments of the invention. Inthis formation, with 19.6% by weight of the accelerator side of theflexible polyurethane dimethacrylate (with hydrogenated polybutadiene asthe flexible unit), or about 9.8% by weight of the total compositematerial after combination of the accelerator side and the catalystside, an excellent flexural strength is achieved in combination with farsuperior deflection-at-break properties. The mechanical properties ofembodiments of the invention in comparison to other commerciallyavailable provisional materials are included below in Table 1. Testswere conducted on an Instron Model 1011 Universal Testing Machine. Asshown in Table 1, embodiments of the present invention (designated asTufftemp) have far superior deflection-at-break properties compared toother commercially available provisional materials. Luxatemp iscommercially available from DMG of Germany, and Protemp Plus iscommercially available from 3M, St. Paul, Minn. As shown in FIG. 1, thetoughness of the composite materials produced from embodiments of theinvention (Tufftemp), determined by measuring the area under thestress-strain curve obtained from the flexural strength measurements, issubstantially greater than and far superior to the aforementioned othercommercially available materials. With slight modifications in theamount of polyurethane dimethacrylate prepolymers or the ratio oforganic matrix to filler, a deflection-at-break of up to 3.2 mm may beachieved.

TABLE 1 Protemp Tufftemp Tufftemp Group Luxatemp Plus (self Cure) (lightCure)^(b) 10 min. 13.4 15.2 29.5 54.3 (S.D. 7.0) (S.D. 1.9) (S.D. 3.5)(S.D. 4.9) 24 h^(a) 69.5 72.2 74 76.2 (S.D. 6.9) (S.D. 5.6) (S.D. 3.4)(S.D. 5.3) Toughness^(c) 265 KJ/m³ 342 KJ/m³ 431 KJ/m³ 424 KJ/m³^(a)specimens were stored in distilled water at 37° C. for 24 hrs.^(b)specimens were prepared by light curing 40 sec on a PROCURE dentallight chamber. ^(c)toughness of the material is measured after thespecimens were stored for 24 hrs. at 37° C.

Example 5

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 27.0 Polyurethanedimethacrylate 19.6 with Polyester Flexible Units polyetherdimethacrylate 7.5 alkyl dimethacrylate 7.2 Glass filler 33.0 amorphoussilica 5.2 photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 62.0

deflection (mm): 2.3

Compressive strength (Mpa): 285

Results:

Example 5 demonstrates properties derived by inclusion of thepolyurethane dimethacrylate prepolymers wherein the flexible unit ispolyester. In this formation, with the flexible polyurethanedimethacrylate accounting for 19.6% by weight of the accelerator side,or about 9.8% by weight of the total composite material, an excellentflexural strength is once again achieved in combination with farsuperior deflection-at-break properties.

Example 6

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 40.2 Polyurethanedimethacrylate 10.0 with HPB Polybutadiene Flexible Units polyetherdimethacrylate 7.5 alkyl dimethacrylate 2.9 Glass filler 33.0 amorphoussilica 5.3 photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 84.5

Deflection-at-break (mm): 2.3

Compressive strength (Mpa): 254

Results:

Example 6 demonstrates a polymerized composite material wherein 10% byweight of the accelerator side, or 5% by weight of the total composite,is comprised of polyurethane dimethacrylate prepolymers withhydrogenated polybutadiene flexible units. This material has excellentflexural strength and compressive strength but has a deflection at breaklower than Example 4. The material is a good fit for single unit crowns.

Example 7

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 10.0 Polyurethanedimethacrylate 40.3 with HPB Polybutadiene Flexible Units polyetherdimethacrylate 7.5 alkyl dimethacrylate 2.8 Glass filler 33.2 amorphoussilica 5.3 photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 52.3 Polyethylene glycoldimethacrylate 7.7 Glass filler 34.0 amorphous silica 5.4 benzoylperoxide 0.73 BHT 0.035

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 48.6

Deflection-at-break (mm): 3.3

Compressive strength (Mpa): 131

Results:

Example 7 demonstrates a polymerized composite material whereinapproximately 40% by weight of the accelerator side, or approximately20% by weight of the total composite, is comprised of polyurethanedimethacrylate prepolymers with hydrogenated polybutadiene flexibleunits. Although this example has excellent deflection and good flexuralproperties, it has low compressive strength. This material can be achoice for crown and bridge materials.

Example 8

Accelerator Side:

Ingredient Percent Urethane dimethacrylate 0.0 Polyurethanedimethacrylate- 62.7 with HPB Flexible Units polyether dimethacrylate0.0 alkyl dimethacrylate 0.0 Glass filler 33.7 amorphous silica 2.7photoinitiator 0.14 amine 0.75 BHT 0.001Catalyst Side:

Ingredient Percent Urethane dimethacrylate 25.9 Polyurethanedimethacrylate- 25.9 with HPB Flexible Units Polyethylene glycoldimethacrylate 7.5 Glass filler 37.1 amorphous silica 2.8 benzoylperoxide 0.73 BHT 0.030

Mixing equal parts of accelerator and catalyst caused the material tocure to a hard resin. The resin mix can also undergo visible light curepolymerization.

Properties:

Flexural strength (Mpa): 35

deflection (mm): 4.4

Compressive strength (Mpa): 103

Results:

Example 8 demonstrates properties derived by inclusion of thepolyurethane dimethacrylate prepolymers wherein the flexible unit ishydrogenated polybutadiene. In this formulation, the flexiblepolyurethane dimethacrylate accounts for 100% of the dimethacrylates onthe accelerator side and 43.7% of the dimethacrylates on the catalystside (about 71.9% by weight of the total dimethacrylates) and 62.7% byweight of the entire accelerator side and 25.9% by weight of the entirecatalyst side (about 44.3% by weight of the total composite material).The material exhibits a high degree of deflection at break (4.4 mm), butpoor flexural and compressive strengths. Although this material is notsuitable for crown and bridge applications, it is suitable as a denturereline material where high toughness as well as a high degree ofdeflection is required.

CONCLUSIONS

Polyurethane dimethacrylate materials with flexible units have greaterflexibility than their alkyl dimethacrylate analogues, and provide suchflexibility without compromising flexural strength.

1. A radically curable polyurethane composite for dental restorationcomprising: (A) about 5-45% by total weight of the composite of apolyurethane dimethacrylate prepolymer blended in at least one aproticmethyacrylate monomer, wherein the prepolymer includes at least oneflexible unit within a polyurethane dimethacrylate backbone; and (B)about 15-60% by total weight of the composite of one or moredimethacrylate monomers.
 2. The radically curable polyurethane compositeof claim 1, wherein the reactive flexible unit is selected from a groupcomprising hydrogenated polybutadiene diol, polyester diol and polyetherdiol.
 3. The radically curable polyurethane composite of claim 1,wherein the at least one aprotic methyacrylate monomer is selected froma group comprising triethylene glycol dimethacrylate, tetraethyleneglycol dimethacrylate, polyethylene glycol dimethacrylate, polyethyleneglycol methacrylate monomethyl ether, tetramethylene dimethacrylate,hexamethylene dimethacrylate, octmethylene dimethacrylate, anddodecamethylene dimethacrylate.
 4. The radically curable polyurethanecomposite of claim 1, further comprising a photoinitiator system.
 5. Theradically curable polyurethane composite of claim 4, wherein thephotoinitiator system includes a polymerization inhibitor selected froma group consisting of butylated hydroxytoluene or hydroquinonemonomethyl ether, and combinations thereof.
 6. The radically curablepolyurethane composite of claim 4, wherein the photoinitiator systemcomprises a light sensitive photoinitiator selected from a groupcomprising camphorquinone, phenyl-propanedione, acylphosphine oxide, andan amine co-initiator.
 7. The radically curable polyurethane compositeof claim 1, wherein the one or more dimethyacrylate monomers areselected from a group comprising polyether dimethacrylate, alkyldimethacrylate, polyester dimethacrylate and combinations thereof. 8.The radically curable polyurethane composite of claim 1, furthercomprising a nonreactive filler selected from a group consisting ofbarium glass, barium borosilicate glass, strontium glass, submicronsilica and combinations thereof.
 9. The radically curable polyurethanecomposite of claim 1, further comprising a catalyst selected from agroup comprising dibenzoyl peroxide, 2,2-(4-methylphenylimino)diethanol,dimethylaminoethyl methacrylate, N,N-dimethyl-p-toluindine, benzil,N,N-dimethylaminoethyl-methacrylate, benzoinmethylether and combinationsthereof.
 10. The radically curable polyurethane composite of claim 1,wherein the composite comprises a urethane dimethacrylate that includesat least one polybutadiene molecule within the urethane dimethacrylate.11. The radically curable polyurethane composite of claim 1, wherein thecomposite has a deflection-at-break of 2.3 to 3.2 mm after curing.
 12. Amethod of treating a tooth, comprising: providing a radically curablepolyurethane composite for dental restoration comprising: (A) about5-45% by total weight of the composite of a polyurethane dimethacrylateprepolymer blended in at least one aprotic methyacrylate monomer,wherein the prepolymer includes at least one flexible unit within apolyurethane dimethacrylate backbone; and (B) about 15-60% by totalweight of the composite of one or more dimethacrylate monomers; applyingthe composite material to at least a portion of a surface of one or moreteeth; curing the polymerizable composite material so that the compositematerial polymerizes; and affixing the polymerized composite to the oneor more teeth.
 13. The method of claim 12, wherein the polymerizablecomposite material further comprises one or more dimethacrylatemonomers, a catalyst, and non-reactive filler, and wherein the flexibleunit is selected from a group comprising polybutadiene diol, polyesterdiol and polyether diol.
 14. The method of claim 12, further comprising:trimming the polymerized composite so that it substantially replicatesthe surface of one or more teeth and creates an anatomically correctmargin; optionally applying a sealant to the polymerized composite; andaffixing the polymerized composite to one or more teeth.
 15. The methodof claim 12, wherein the polymerized composite comprises a provisionaldental prosthesis.